Preoperative identification of the Adamkiewicz artery (AKA) with adequate reconstruction or preservation during surgery is useful for protecting the spinal cord from ischemia during thoracoabdominal aortic repair. However, the identification of the AKA remains challenging in some cases, especially with chronic aortic dissection. In a 45-year-old man with chronic aortic dissection requiring thoracoabdominal aortic repair, conventional contrast-enhanced CT or MR angiography failed to detect AKA due to the large entry tear and an enlarged false lumen.
View Article and Find Full Text PDFThe management of locally advanced esophageal cancer typically involves esophagectomy; however, postoperative complications, particularly anastomotic stricture, remain prevalent. Anastomotic stricture can severely compromise patients' quality of life by leading to difficulties in food intake. Although endoscopic balloon dilation has become a standard treatment for gastrointestinal strictures, its efficacy is often limited due to the risk of perforation and the potential for recurrent stricture, necessitating multiple interventions.
View Article and Find Full Text PDFBackground: Off-label under- and overdosing of direct oral anticoagulants (DOACs) in patients with atrial fibrillation (AF) is not uncommon in real-world practice.
Objective: This study aimed to identify efficacy and safety of off-label DOACs dose after AF ablation.
Methods: The RYOUMA registry was a prospective multicenter study of Japanese patients who underwent AF ablation between 2017 and 2018.
Background: The standard adjuvant chemotherapy regimen for stage III gastric cancer is docetaxel plus S-1 (DS) based on the results of the START-II trials. However, in clinical practice some patients could not continue this intensive doublet chemotherapy because of limited tolerability. This study aimed to assess the practical feasibility of DS and elucidate the predictive factors for the completion of adjuvant DS therapy.
View Article and Find Full Text PDFLeft atrial appendage closure is widely performed in cardiac surgery to prevent intracardiac thrombus in patients with atrial fibrillation. Herein, we report the surgical case of an 80-year-old man whose left atrial appendage became aneurysmic long after undergoing suture exclusion. At the age of 67, he underwent mitral valve annuloplasty and left atrial appendage suture exclusion for mitral regurgitation and chronic atrial fibrillation at our institution.
View Article and Find Full Text PDF